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nitrous oxide exposure can inactivate B12 Important: Do not take folic acid alone when B12 deficiency is possible or uncorrected, as this may worsen neurological damage Avoid measuring serum B12 immediately after injections due to falsely high results Dietary optimisation remains the preferred approach for those without absorption issues

Contamination prevention Every time you puncture the rubber stopper, you introduce a potential contamination pathway

There can be tolerance with repeated use, which degrades efficacy and increases doses, leading to safety concerns

Why haven't I heard of this before

This reaction simultaneously depletes two critically important metabolic cofactors: SAM (the universal methyl donor for hundreds of epigenetic and biosynthetic reactions) and nicotinamide (the precursor for NAD+ biosynthesis via the salvage pathway)